Individual provider Active NPI

Bonnie Stanford

  • Counselor
  • South Daytona, FL
National Provider Identifier
1679016455
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
2400 S Ridgewood Ave
South Daytona, FL 32119-3097
Phone
(386) 304-7600
NPI assigned
Nov 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

2400 S Ridgewood Ave
South Daytona, FL 32119-3097

Mailing address

918 3Rd St
Port Orange, FL 32129-3206
Phone (850) 443-6843

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260202001141 ME Practitioner - Clinical Social Worker 5193203073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthy Minds Counseling IncGroup PAC ID 0840729562, 18 clinicians

Practice addresses (Care Compare)

222 Auburn St
Suite 103
Portland, ME 04103-6005
Phone (207) 616-1127

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Minds Counseling, Inc. CurrentSince Jan 16, 2026 Accepting new patients

Locations

222 Auburn St
Ste 103
Portland, ME 04103
Phone (207) 373-8522

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1679016455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 3RD ST",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321293206",
            "telephone_number": "850-443-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S RIDGEWOOD AVE",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193097",
            "telephone_number": "386-304-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "BONNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-28",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

Verify at the official NPI Registry.